Intra-abdominal organ manipulator, irrigator, aspirator and method

ABSTRACT

A method of using an intra-abdominal organ manipulator, irrigator and/or aspirator, which includes a tubular probe member with distal and proximal ends and a through lumen extending the length thereof, is described. A balloon is affixed to the distal end to aid in manipulating organs or parts thereof within the abdominal cavity when inflated through an auxiliary lumen in the probe. A handle attached to the proximal end of the probe has a pair of trumpet valves which allow the user to connect a vacuum source or irrigation fluid source to the through lumen.

RELATED APPLICATION

This application is a division of application serial no. 07/637,592,filed Jan. 3, 1991 for and INTRA-ABDOMINAL ORGAN MANIPULATOR, IRRIGATORASPIRATOR AND METHOD (now U.S. Pat. No. 5,197,948).

BACKGROUND OF THE INVENTION

1. Field of the Invention

The present invention relates to the surgical instrument art and moreparticularly to a surgical instrument and method for manipulating,irrigating and aspirating organs and tissue within a surgical area inthe abdominal cavity.

2. Description of the Prior Art

In many surgical procedures within the abdominal cavity it is importantand difficult to move or manipulate organs or parts thereof (such assections of the bowel) in order to observe and operate on a particularorgan or tissue section within that cavity. It is also often necessaryto flush (irrigate) the surgical area with an appropriate fluid (e.g.,antiseptic) and/or remove (aspirate) fluid from the area during theoperation. Prior art instruments for irrigation and aspiration purposesare available in the form of elongated tubes open at the distal end andequipped with finger operated valves for connecting a source of fluid orvacuum source to the tube. However, such prior art irrigation andaspiration devices which provide only a small tubular tip within theabdominal cavity are ill equipped to manipulate organs or parts thereofso that the surgeon (user) can readily locate the area or organ ofinterest.

Other prior art devices such as the one described in U.S. Pat. No.4,744,363 ("'363 patent") are designed so that the tip of the instrumentis in the form of a relatively stiff split sleeve which may be expandedto provide a greater surface area with which to move an organ out of theway. The split sleeve would not provide a smooth continuous surface withwhich to manipulate organs or tissue. Also the '363 device would notreadily accommodate structure for irrigating and/or aspirating thesurgical area. U.S. Pat. Nos. 4,617,013 and 4,759,349 discloseinstruments for irrigating, aspirating and illuminating surgical areas.However, these instruments are designed for use in an open abdomeninstead of in a closed abdomen (laparoscopy). Furthermore, such priorart instruments are complicated and do not provide any convenient meansfor moving organs or tissue out of the way to facilitate surgery orother treatment on the desired organ or tissue.

The above disadvantages as well as others inherent in the prior artdevices are overcome by the present invention.

SUMMARY OF THE INVENTION

In accordance with the present apparatus a surgical instrument forenabling a surgeon to manipulate, irrigate and aspirate organs within asurgical area includes a tubular probe with distal and proximal ends anda through lumen. The instrument of this invention may be used in an openor closed abdominal surgery (e.g., laparotomy, laparascopyrespectively). The distal end of the probe is open and preferably thatend defines a plurality of holes so that fluid may pass from the throughlumen to the surgical area surrounding the distal end of the probe viathe holes and open distal end and visa versa. A handle member isattached to the proximal end of the probe and includes a centralpassageway therein connected to the through lumen so that fluid can besupplied to or removed from the body cavity or organ in which the distalend of the probe is inserted.

An inflatable balloon is secured to the exterior of the probe adjacentthe distal end so that the interior of the balloon is isolated from thethrough lumen. An auxiliary lumen extends along the length of the probeand is in fluid communication with the interior of the balloon so thatfluid may be supplied to or removed from the interior of the balloon toinflate and deflate the same.

In accordance with the present method the distal end of the probedescribed above is inserted into the surgical area. The balloon is theninflated and the distal end of the probe and the inflated balloon arepositioned against the organ or part thereof to be moved. The distal endof the probe is then moved until the organ or part thereof isrepositioned as desired and the surgical procedure completed. Theballoon is then deflated and the probe withdrawn.

The features of the present invention can best be understood byreference to the following description, taken in conjunction with theaccompanying drawings wherein like numerals indicate like parts.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a medical probe and handle in accordancewith the present invention;

FIG. 2 is a enlarged perspective view of a portion of the probe andhandle of the instrument of FIG. 1;

FIG. 3 is a cross-sectional view of the instrument taken along lines3--3 in FIG. 1; and

FIG. 4 is a cross-sectional view of one of the finger operated trumpetvalves for controlling the flow of fluid to or from the handle of theinstrument taken along lines 4--4 in FIG. 2.

FIG. 5 is a schematic diagram showing the instrument of FIG. 1 in use.

FIG. 6 is a cross-sectional view of the distal end of the probe insertedinto a cyst, organ or surgical area illustrating the method ofirrigating such area.

FIG. 7 is a cross-sectional view of the distal end of the probe insertedinto a cyst, organ or surgical area illustrating the method ofaspirating or removing fluid from such area.

DESCRIPTION OF THE PREFERRED EMBODIMENT

Referring now to the drawings and more particularly to FIGS. 1-3, themedical instrument includes an elongated tubular probe member 10. Theprobe 10 has a distal end 12 and a proximal end 14. A passageway orthrough lumen 16 extends the length of the probe 10 from its open distalend to its proximal end 14. A plurality of holes 19 are arranged in thewall of the probe adjacent its distal end 12 as illustrated. Aninflatable flexible membrane in the form of a balloon 20 has its outerends 22 and 24 secured in an airtight manner to the outer periphery ofthe tubular probe 10 adjacent the holes 19. The probe includes anadditional passageway or auxiliary lumen 26 extending along its lengthin fluid communication with the interior of the balloon 20 via opening28 in the probe wall. The auxiliary lumen terminates in a flexible tube30 adjacent the proximal end 14 of the probe 10. Fluid may be injectedinto or withdrawn from the tube 30 to inflate or deflate the balloon 20as will be explained more fully in conjunction with FIG. 5.

The proximal end of the probe 10 is slidably received in a bore 32 of ahandle member 34. A set screw 36 secures the handle and probe together.The handle defines a central passageway 38, an aspiration port 40 and anirrigation port 42 in fluid communication with the through lumen 16 asshown in FIG. 3. A threaded plug 44 closes the end of the centralpassageway 38 in the handle 34.

Finger actuated trumpet valves 48 and 50 are connected in the aspirationand irrigation ports 40 and 42, respectively. The valve bodies may beformed integrally with the handle 34 as is illustrated in FIG. 4. Eachvalve includes an inlet port 52, a lateral passageway 53 whichaccommodates a sliding valve member 54 with a passageway 56, acompression spring 58 which biases the valve member 54 in the closedposition (shown in FIG. 4), and a finger operated plunger 60 connectedto the valve member 54 for opening the valve in response to a user'sfinger pressure. Threaded plugs 62 and 64 close the passageway 53.

The tubular probe 10 and the handle 32 may be manufactured of metal suchas stainless steel. Preferably the probe 10 is made of a carbonimpregnated plastic such as PVC, vinyl or epoxy so that when exposed tolaser radiation it will not inflame and burn the surrounding tissue. Theprobe 10 may be disposable to eliminate the need for sterilization afteruse. The outer diameter of the probe 10 is preferably within the rangeof about 3-6 mm and most preferably about 4 mm. The diameter of thethrough lumen 16 is preferably within the range of 1-5 mm and mostpreferably about 3 mm. The length of the probe 10 is preferably about 25cm.

Referring now to FIGS. 5-7, the distal end of the probe member 10 withthe balloon 20 deflated is inserted through an incision in the abdominalcavity via a conventional trocar sleeve (not shown). The balloon is theninflated with a fluid such as a gas (i.e., air) or a liquid (e.g.,water) to an appropriate diameter e.g., 20-30 mm via a valved flexiblereceptacle 65 and a syringe or other source of pressurized fluid 68. Thevalved receptacle is connected to the flexible tube 30 and includes aspring loaded normally closed valve (not shown) in the end 67 thereof.The needle 68a at the end of the syringe opens the valve to allow fluidto enter the tube 30. Once the balloon is inflated the syringe may beremoved from the valved receptacle. The appearance of the receptacle 65,i.e., whether extended or collapsed, informs the user or surgeon of thecondition of the balloon 20, i.e., whether inflated or deflated.

Once the balloon 20 is inflated, the probe's distal end with theinflated balloon is positioned against an organ or part thereof (e.g.,the bowel) to be moved. The distal end is then moved until the organ orpart thereof is repositioned as desired. To aid in manipulating theorgan, the balloon may be provided with a roughened surface as isillustrated, for example, in FIG. 5, to increase its surface friction.The surgical area into which the distal end has been inserted may thenbe irrigated to flush the area or aspirated to remove fluid or solidmaterial from the area or organ. The irrigating liquid may be suppliedfrom a suitable source 70 of such liquid under pressure via the fingeroperated valve 50. Liquid and/or solids may be removed for the surgicalarea or organ by connecting the through lumen 10 of the probe to asuitable vacuum source 72 via valve 48. The balloon may be deflated forremoval from the abdominal cavity by withdrawing fluid through theauxiliary lumen via the receptacle 65 and syringe 68.

The distal end of the probe may also be inserted into an organ (e.g.,gall bladder) or growth such as a cyst 69 while the balloon is deflated.Once the distal end and balloon is within the cyst 69 the balloon may beinflated and positioned against the point of entry to provide a sealingaction against the cyst wall to minimize the leakage of fluid from thecyst (or organ) into the abdominal cavity as is shown in FIGS. 6 and 7.The interior of the cyst may be irrigated as is illustrated in FIG. 6 oraspirated as is illustrated in FIG. 7.

There has thus been described a intra-abdominal organ manipulator,irrigator and/or aspirator and method of using the same. Variousmodifications will be apparent to those skilled in the art withoutinvolving any departure from the spirit and scope of my invention asdefined in the appended claims.

What is claimed is:
 1. A method of manipulating organs or parts thereofwithin a patient's abdominal cavity and aspirating the interior of anorgan, growth or cyst located within said cavity with a surgical probehaving distal and proximal ends, a through lumen open at the distal end,an inflatable balloon affixed to the exterior of the probe adjacent thedistal end thereof and means for inflating/deflating the balloon and forselectively connecting the through lumen to a low pressure sourcecomprising the steps of:a) manually inserting the distal end of theprobe into the abdominal cavity so that the probe end is positionedoutside of the organ to be manipulated; b) inflating the balloon; c)positioning the balloon and distal end of the probe against the organ orpart thereof to be moved; d) moving the distal end of the probe untilthe organ or part thereof is repositioned as desired; e) deflating theballoon; f) manually inserting the distal end of the probe into theorgan, growth or cyst to be aspirated; g) inflating the balloon; h)positioning the balloon against the interior wall of the organ, growthor cyst adjacent the point of entry to minimize the leakage of fluidfrom the organ growth or cyst into the abdominal cavity; i) connectingthe through lumen to the low pressure source to aspirate fluid from theorgan growth or cyst; j) deflating the balloon; and k) withdrawing theprobe.
 2. The method of claim 1 wherein the probe further includes meansfor selectively connecting the through lumen to a source of irrigationfluid and further including the step of connecting the through lumen tothe source of irrigation fluid while the distal end of the probe isinserted into the organ, growth or cyst to irrigate the organ, growth orcyst.